Hair Care Assessment Form
Fill out the form carefully please!
Squad Member Name
*
First Name
Middle Name
Last Name
Gender
*
Please Select
Male
Female
N/A
Parent E-mail
*
example@example.com
Parent Phone Number
*
Emergency Contact
*
undefined
Emergency Contact name
*
First Name
Last Name
What is the current state of your hair? (Ex. Protective style)
*
Is your hair Relaxed or Natural?
*
Natural
Relaxed
Is your hair damaged or healthy
*
Damaged
Healthy
Unsure
What is your scalp condition? (Ex. Never really experienced dandruff or often struggles with dandruff)
*
Are you allergic to any products? (This includes any negative reactions you may have had in the past)
*
Yes
No
If you answered “Yes” above what are you allergic to?
What are some struggles you are having with your hair not mentioned on this form, if any?
Submit
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